IntroductionBreast cancer survival rates are lower for African American women than for white women. Obesity, high-fat diets, and lack of regular physical activity increase risk for breast cancer recurrence, comorbid conditions, and premature death. Eighty-two percent of African American women are overweight or obese, partly because of unhealthy eating and exercise patterns. Although successful weight loss and lifestyle interventions for breast cancer survivors are documented, none has considered the needs of African American breast cancer survivors. This study assessed the feasibility and impact of Moving Forward, a culturally tailored weight loss program for African American breast cancer survivors.MethodsThe study used a pre-post design with a convenience sample of 23 African American breast cancer survivors. The 6-month intervention was theory-based and incorporated qualitative data from focus groups with the targeted community, urban African American breast cancer survivors. Data on weight, body mass index (BMI), diet, physical activity, social support, and quality of life were collected at baseline and at 6 months.ResultsAfter the intervention, we noted significant differences in weight, BMI, dietary fat intake, vegetable consumption, vigorous physical activity, and social support.ConclusionThis is the first published report of Moving Forward, a weight loss intervention designed for African American breast cancer survivors. Although a randomized trial is needed to establish efficacy, the positive results of this intervention suggest that this weight loss intervention may be feasible for African American breast cancer survivors. Lifestyle interventions may reduce the disparities in breast cancer mortality rates.
Background Despite the rising popularity of plant-based alternative meats, there is limited evidence of the health effects of these products. Objectives We aimed to compare the effect of consuming plant-based alternative meat (Plant) as opposed to animal meat (Animal) on health factors. The primary outcome was fasting serum trimethylamine-N-oxide (TMAO). Secondary outcomes included fasting insulin-like growth factor 1, lipids, glucose, insulin, blood pressure, and weight. Methods SWAP-MEAT (The Study With Appetizing Plantfood—Meat Eating Alternatives Trial) was a single-site, randomized crossover trial with no washout period. Participants received Plant and Animal products, dietary counseling, lab assessments, microbiome assessments (16S), and anthropometric measurements. Participants were instructed to consume ≥2 servings/d of Plant compared with Animal for 8 wk each, while keeping all other foods and beverages as similar as possible between the 2 phases. Results The 36 participants who provided complete data for both crossover phases included 67% women, were 69% Caucasian, had a mean ± SD age 50 ± 14 y, and BMI 28 ± 5 kg/m2. Mean ± SD servings per day were not different by intervention sequence: 2.5 ± 0.6 compared with 2.6 ± 0.7 for Plant and Animal, respectively (P = 0.76). Mean ± SEM TMAO concentrations were significantly lower overall for Plant (2.7 ± 0.3) than for Animal (4.7 ± 0.9) (P = 0.012), but a significant order effect was observed (P = 0.023). TMAO concentrations were significantly lower for Plant among the n = 18 who received Plant second (2.9 ± 0.4 compared with 6.4 ± 1.5, Plant compared with Animal, P = 0.007), but not for the n = 18 who received Plant first (2.5 ± 0.4 compared with 3.0 ± 0.6, Plant compared with Animal, P = 0.23). Exploratory analyses of the microbiome failed to reveal possible responder compared with nonresponder factors. Mean ± SEM LDL-cholesterol concentrations (109.9 ± 4.5 compared with 120.7 ± 4.5 mg/dL, P = 0.002) and weight (78.7 ± 3.0 compared with 79.6 ± 3.0 kg, P < 0.001) were lower during the Plant phase. Conclusions Among generally healthy adults, contrasting Plant with Animal intake, while keeping all other dietary components similar, the Plant products improved several cardiovascular disease risk factors, including TMAO; there were no adverse effects on risk factors from the Plant products. This trial was registered at clinicaltrials.gov as NCT03718988.
The evolution of dietary guidelines from isolated nutrients to broader dietary pattern recommendations results from growing knowledge of the synergy between nutrients and their food sources as they influence health. Macronutrient and micronutrient needs can be met by consuming various dietary patterns, but guidance is often required to facilitate population-wide adherence to wise food choices to achieve a healthy dietary pattern. This is particularly true in this era with the proliferation of nutrition misinformation and misplaced emphasis. In 2021, the American Heart Association issued a scientific statement outlining key principles of a heart-healthy dietary pattern that could be operationalized in various ways. The objective of this scientific statement is to assess alignment of commonly practiced US dietary patterns with the recently published American Heart Association criteria, to determine clinical and cultural factors that affect long-term adherence, and to propose approaches for adoption of healthy dietary patterns. This scientific statement is intended to serve as a tool for clinicians and consumers to evaluate whether these popular dietary pattern(s) promote cardiometabolic health and suggests factors to consider when adopting any pattern to improve alignment with the 2021 American Heart Association Dietary Guidance. Numerous patterns strongly aligned with 2021 American Heart Association Dietary Guidance (ie, Mediterranean, DASH [Dietary Approaches to Stop Hypertension], pescetarian, vegetarian) can be adapted to reflect personal and cultural preferences and budgetary constraints. Thus, optimal cardiovascular health would be best supported by developing a food environment that supports adherence to these patterns wherever food is prepared or consumed.
Increasing attention has been given to the role of retail food environments in shaping dietary behavior and obesity risk. Studies have generally shown an association between living in a neighborhood with or in close proximity to certain types of food outlets and/or the availability of healthy food options and better dietary quality, higher fruit/vegetable intakes, and a lower risk of overweight, even after controlling for individual/family level characteristics. However, research in this area has yielded mixed results, overall. Future research needs to identify consistent approaches for defining and measuring food retail environments.
Objectives Non-Hispanic black (NHB) men have higher rates of chronic disease than men in other racial/ethnic groups. Poor diet quality is one risk factor for chronic disease, but research on the diet quality and nutrient intake of NHB men is sparse. The objective of this study was to describe and compare the diet quality and nutrient intake of NHB and non-Hispanic white (NHW) men in the United States. Methods We analyzed cross-sectional data on 5050 men (31.3% NHB, 68.7% NHW) who participated in the National Health and Nutrition Examination Survey (NHANES) during 2007-2012. To assess diet quality, we calculated Healthy Eating Index (HEI)–2010 scores from each participant’s 24-hour recall data. We used logistic regression models to determine if NHB men had lower odds of meeting dietary recommendations for nutrient intake than NHW men. We used linear regression models to identify significant differences in HEI-2010 scores between NHB and NHW men. Results After adjusting for sociodemographic measures, NHB and NHW men had similar diet quality ( P = .59). Compared with NHW men, NHB men had lower odds of meeting recommendations for dietary fiber and cholesterol intake and higher odds of meeting recommendations for saturated fat and sodium intake. Conclusion Differences between NHB and NHW men in the intake of certain nutrients may be related to chronic disease disparities. Future research should consider racial/ethnic differences in dietary intake among men and the impact these differences have on men’s health.
Purpose The American Cancer Society (ACS) and the American Institute for Cancer Research (AICR) each created dietary and physical activity guidelines to improve cancer survivorship. Despite African American breast cancer survivors (AABCS) having the lowest survival rates of any racial or ethnic group, limited information exists on their adherence to cancer specific lifestyle recommendations. The study’s purpose was to measure adherence to ACS/AICR dietary recommendations in AABCS. Methods 210 AABCS enrolled in the Moving Forward intervention trial, a randomized, community-based, 6-month weight loss study, were assessed for sociodemographics, dietary intake (via food frequency questionnaire) and related health factors at baseline. We operationalized the dietary recommendations put forth by ACS/AICR and created component and total adherence index scores. Descriptive statistics were used to calculate the proportion of women who met recommendations. Student’s t-test and χ2 tests were used to compare participant characteristics by median adherence scores. Results The mean total ACS/AICR score was 12.7 ± 2.5 out of 21 points (median: 13; range: 5 to 21). Over 90% were moderately or completely adherent to limiting alcohol and red and processed meat consumption, but the majority failed to meet the other recommendations to eat whole grains, legumes, fruits, vegetables, and avoid added sugars. Women with total scores below the median were younger, with higher BMI, had fewer years of education, and lower income levels. Implications for Cancer Survivors The present study extends the literature on AABCS adherence to cancer-survivor specific dietary guidelines. Findings will inform future dietary lifestyle interventions in this population.
Results from this study suggest that dietary fiber consumption may be particularly important within weight loss interventions tailored for African-American women.
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